Work-related injuries and illnesses are a significant public health problem in Massachusetts, imposing substantial human and economic costs. Massachusetts recognizes the prevention of work-related injuries and illnesses as a public health priority and the need for state-based surveillance to promote effective intervention and prevention activities at the state and local levels. State surveillance findings can also fill gaps in occupational health surveillance at the national level. Established in 1986, the Occupational Health Surveillance Program (OHSP) in the Massachusetts Department of Public Health (MDPH) collects, analyzes and disseminates information about work-related injuries, illness and hazards to promote prevention efforts in the state. In the summer of 2005, the Massachusetts Department of Public Health was awarded NIOSH funding to implement an Expanded Occupational Health Surveillance Program. The Expanded Program includes fundamental surveillance activities and three focused surveillance and intervention projects addressing one priority health condition - sharps injuries to hospital workers, and two priority worker populations - working youths less than 18 years of age, and immigrant and minority workers. OHSP is requesting supplemental support to extend this Expanded Program to address two additional priority occupational health conditions: traumatic occupational fatalities and work-related asthma. Specifically, OHSP proposes to continue and enhance the ongoing Massachusetts Fatality Assessment and Control Evaluation (FACE) Project and the Massachusetts surveillance system for work-related asthma as integral components of the Expanded Program. The aims of the two proposed projects,are consistent with the overarching aim of the Expanded Program to reduce the incidence of work-related injuries and illnesses in Massachusetts. Proposed activities include innovative and cost effective collaborations between both Massachusetts FACE and the work-related asthma project and the existing projects within the Expanded Program. Both proposed projects also build on OHSP's fundamental activities promoting partnerships with stakeholders in MDPH, the state and the region. All Expanded Program activities will be guided by the OHSP Advisory Board comprised of local occupational health experts and advocates.